Provider Demographics
NPI:1194869057
Name:RITCHEY, DONALD B (DPM)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:B
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 CHESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-1085
Mailing Address - Country:US
Mailing Address - Phone:765-962-0521
Mailing Address - Fax:765-962-1610
Practice Address - Street 1:3923 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1085
Practice Address - Country:US
Practice Address - Phone:765-962-0521
Practice Address - Fax:765-962-1610
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN07000397A213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100326330CMedicaid
T34639Medicare UPIN
217460Medicare ID - Type Unspecified